New York Medicaid Program To Stop Reimbursing Hospitals For Preventable Errors

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Public Health
Article Date: 11 Jun 2008 - 9:00 PDT

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New York state Department of Health officials have announced the state Medicaid program in October will stop reimbursing hospitals for preventable errors, known as "never events," the AP/New York Daily News reports. According to the AP/Daily News, the state is mirroring CMS' actions for Medicare on never events (Bauman, AP/New York Daily News, 6/5).

CMS officials in August 2007 announced that Medicare -- beginning in October 2008 -- no longer will reimburse hospitals for the treatment of preventable errors, injuries and infections that occur in the facilities. The eight conditions for which Medicare no longer will reimburse hospitals for treatment include: falls; mediastinitis, an infection that can develop after heart surgery; urinary tract infections that result from improper use of catheters; pressure ulcers; and vascular infections that result from improper use of catheters. In addition, the conditions include three "never events": objects left in the body during surgery, air embolisms and blood incompatibility (Kaiser Daily Health Policy Report, 8/20/07).

According to the AP/Daily News, New York's Medicaid program will halt payments for preventable errors such as wrong-site surgery, wrong-patient treatments, disabilities associated with treatment, medication errors and other errors. Health Department spokesperson Claudia Hutton said the state will not allow beneficiaries to be billed for care for which the state has denied payment.

Extent of Issue
The state health department currently tracks preventable errors. In 2007, 20 procedures were performed on the wrong patient or body part in the state; 106 incorrect procedures or treatments were performed or performed on the wrong patient; and 26 medication errors were committed, six of which resulted in permanent patient harm, 11 in near death and nine in death. In addition, there were 122 cases in 2007 in which medical professionals left foreign objects inside a patient's body cavity after surgery. The health department expects the policy to reduce program expenditures by $6 million. New York's Medicaid program spends $47 billion annually, the highest spending state Medicaid program in the U.S.

Reaction
William Van Slyke, a spokesperson for the Healthcare Association of New York State, said his association already had adopted its own policies for preventable errors but questioned portions of the new plan. Van Slyke said what the health department considers preventable "may not always be preventable by a hospital" (AP/New York Daily News, 6/5).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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